Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Shannon Rae Balthazr, PTA

Individual provider Physical Therapy Assistant · NPI 1891869186

Shannon Rae Balthazr, PTA is a Physical Therapy Assistant in Bristol, Tennessee. Practices as a sole proprietor. Licensed in Tennessee.

Licensed in
TN
In the registry since
2006
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

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Practice location Address checks out

1 Medical Park Blvd
Bristol, TN 37620-7430
Phone: (423) 844-4104
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 3766 (TN)

Record details

NPI number1891869186
Entity typeIndividual (Type 1)
GenderFemale
Credentials PTA
Sole proprietorYes
NPI enumeratedNovember 20, 2006
Last updated in NPPESJuly 8, 2007

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